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Reports


Inspection carried out on 26 July 2017

During a routine inspection

This inspection took place on 26 July 2017. The inspection was unannounced.

Veedale is registered to provide accommodation for up to 20 people over the age of 18 with a diagnosis of a learning disability, autistic spectrum, physical disability, sensory impairment and living with a dementia. At the time of our inspection there were 20 people in receipt of care from the service.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At the last comprehensive inspection on 7 January 2015 the service was rated as good overall and was meeting the regulatory requirements relevant at that time. However we made a recommendation in relation to the management of medicines. We also undertook a follow up inspection on 14 July 2016 as a response to an increase in occupancy in the home. The provider submitted the appropriate application to the Care Quality Commission and the service was rated as good in the Well-led domain. During this inspection we found the service was meeting the requirements of the current legislation.

We saw safe administration of medicines during our inspection. Medicines were stored safely in locked cupboards. There was some evidence of temperature recordings of rooms where medicines were stored however the fridge temperature had not been recorded regularly. A full audit of medicines was undertaken immediately by the registered manager and actions taken to ensure the safe administration, storage and recording of medicines was provided. However we made a further recommendation in relation to Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The safe management of medicines.

We saw evidence of completed investigations into allegations of abuse and staff knew the procedure to take if any concerns were identified.

Individual emergency evacuation plans were in place as well as emergency contingency plans to guide staff about the procedure to take when dealing with an emergency. Environmental and personal risk assessments were completed to guide staff on how to protect people who used the service from unnecessary risks.

Staff told us the training they received from the provider was detailed and comprehensive and enabled them to fulfil their role safely. Records we looked at confirmed relevant and regular training was completed by staff to provide them with the skills they required.

Meals provided to people were varied and nutritious and reflected their choices and individual requirements. Where people required monitoring of their food and fluid intake this had been completed. Relevant referral had been made to professionals such as a dietician and speech and language therapist.

It was clear a variety of health professionals was regularly involved in the review of people’s health and needs.

Staff told us they had received up to date training that supported the delivery of care to people who used the service.

Meals in the home were varied and made fresh daily. Where people requested alternative these were provided by the cook. Where required food and fluid intake were recorded to ensure any changes in people’s condition were identified.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Appropriate Deprivation of Liberty Safeguards applications had been submitted to the assessing authority.

Positive, meaningful caring relationships had been developed between staff and people who used the service. It was evident staff knew people’s needs. It was clear people were treated with dignity and resp

Inspection carried out on 14 July 2016

During an inspection to make sure that the improvements required had been made

We carried out an unannounced focused inspection of Veedale on 13 July 2016 to check whether the registered provider was complying with the Company’s conditions of their registration under the Health and Social Care Act 2008 This report only covers our findings in relation to this issue. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Veedale on our website at www.cqc.org.uk.

Veedale is registered to provide care and accommodation for up to 18 young adults who have a learning disability. The home is purpose built with all its facilities being on the ground floor. All accommodation is provided on a single room basis.

At the time of our inspection there were 20 people living at the service. The registered provider is currently registered to accommodate a maximum of 18 people at Veedale.

At the time of our inspection the service had a registered manager who had been in post since January 2014. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Inspection carried out on 7th January 2015

During a routine inspection

We carried out an unannounced inspection on the 7th January 2015. The last inspection took place on 11 July 2013 and there was no evidence of any regulatory breaches.

Veedale is registered to provide care for up to 18 young adults who have a learning disability. The home was providing care and accommodation for people with nursing and personal care needs. The registration requirements for the provider stated the home should have a registered manager in place. There was a registered manager in post on the day of our inspection.

A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

Systems to ensure people who used the service received safe effective care were in place. This was because the provider ensured people had access to specialist input in the planning and delivering of their care. We noted in people’s care files evidence of reviews undertaken by professionals. We saw some doors that should have remained locked were not always secured. This meant there was a risk of people who needed high levels of supervision accessing external areas unobserved.

Duty rotas for each of the units in the home identified appropriate cover in place. Gaps due to sickness were seen to be covered by the home’s own staff team. Staffing levels were determined according to the layout of the building and people’s needs.

We discussed the arrangements in place to manage people’s medicines safely and effectively. Staff confirmed they received medication training and we saw evidence of training recorded on the training matrix in the home. Policies and national guidance were in place to offer guidance and support when dealing with medications in the home. There were some gaps in medicine records.

People told us they enjoyed the meals and choices were on offer. People were observed to have access to drinks at all times during our inspection. We observed the menu choices for the day and the cook told us menus were picked daily by people who used the service and that people would be able to have a meal of their choice if they did not want what was on offer.

Arrangements to ensure people who used the service were cared for by an appropriately trained staff team were in place. This was because the provider had evidence of staff training, including a training schedule in place for the staff team. Topics covered in the training included, fire safety, first aid, moving and handling, health and safety, drugs administration, safe swallowing, epilepsy, autism, intensive interaction and learning disability communication awareness.

Staff we spoke with were able to provide evidence of an understanding of the Mental Capacity Act (MCA 2005) and Deprivation of Liberty Safeguards) DoLS and the appropriate procedure they would take if a person using the service was being deprived of their liberty unlawfully.

We observed people who used the service during activities. We noted staff asked people if they were happy to take part in the session prior to commencing and we noted appropriate equipment and protective clothing was applied.

We observed range of activities the provider offered on the day of our inspection. The registered manager told us the provider had a team of lifestyle staff who were dedicated to activities in the home. The leader in the lifestyle team told us, “We have developed a bespoke day care activity service.

All care files were individualised and reflected people’s current needs including a description of the person’s current health state. We noted care plans and risk assessments were in place and these had been evaluated recently and regularly. Specific needs such as, moving and handling, challenging behaviour, strategies to cope, medication and dietary advice were in place.

We asked the registered manager about how the provider dealt with complaints in the service. We were told, “We have the complaints policy at the front door and a complaints form with actions and time period to deal with them.”

We asked if the home received feedback from staff, people who used the service or their relatives. We were told the provider sent out a dignity questionnaire to all staff and fed back the results about what we are good at and where we need to improve.

Staff we spoke with in the home were positive about the support they received for the management at the home. We were told, “The manager is brilliant and approachable nothing is too big or small for her.”

We saw evidence of staff meetings taking place. Topics discussed were seen including actions, attendees and the aims of the meetings. The registered manager told us they were driving up quality by developing a staff and relative meeting to discuss how improvements can be made in the home.

We saw evidence of audits and monitoring taking place in the home for example, there was a copy of an inspection audit that had taken place recently which detailed care plans and risk assessment audits that had been completed as well as reference to any concerns or complaints that had been received.

Inspection carried out on 11 July 2013

During a routine inspection

During our visit we spoke with some residents of the home. We received some positive feedback which included;

‘’I like it here. I like everybody.’’

‘’They look after me.’’

‘’They are nice, I am always looked after.’’

‘’I know all about my care plan. It’s all about me. You can look at it if you like.’’

Not all the residents of the home were able to give us their views but we saw that they appeared content and comfortable in their surroundings and were comfortable in the presence of staff. We observed a variety of activities, with some residents studying at college, others on trips out and some people doing one to one activities at home.

We heard staff constantly offering choices to residents such as what to eat and what to do. One resident requested a trip out and this was facilitated straight away. We noted that staff approached residents in a positive manner and it was pleasing to see them communicating in a way that people understood. For example, through signing and using picture boards.

During this inspection we assessed standards relating to people’s care, welfare and medication management. We also looked at arrangements for staff recruitment and training and processes used by the provider for monitoring quality within the service. We found evidence that the home was compliant in all the areas we inspected.

Inspection carried out on 16 May 2012

During a routine inspection

On the day of our visit we saw that residents were busy going about their days. Some people were taking part in activities within the home, others were out in the community with support workers. The atmosphere was busy and cheerful.

The majority of residents we met were not able to give us their views about standards in the home but we saw that they looked comfortable and content in their surroundings and clearly got along well with their support staff.

During our visit a young man who had previously stayed at the home for a short amount of time popped in with his carer to say hello to staff. He was clearly very happy to see people at the home. His carer said ‘’Its so welcoming here.’’

We spoke with a number of relatives of people using the service and received some very positive feedback. One person told us ‘’We think this home is absolutely marvellous.’’ She went on to tell us that when her loved one had joined the service she had been taking a lot of medication which made her very drowsy. She said ‘’They got her medication reviewed and she was so much better. She’s now starting to talk to us and walk after years of not doing, which is amazing. We are so pleased.’’

Another relative said of her loved one, ‘’I visit all the time and she is always clean and well dressed and her hair is always nice. She has dry skin but it’s always beautifully moisturised.’’

Other comments from relatives included;

‘’This is a family run place and you are made to feel like part of the family.’’

‘’We have nothing but praise for this home I couldn’t fault it if I tried. ‘’

‘’They go beyond what they have to do. They are so dedicated. I don’t think (name removed) could have a better quality of life anywhere.’’